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Organization
PHYSICAL REHABILITATION LLC
Active
Organization
PHYSICAL REHABILITATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDOLPH M JENKINS JR. MD (OWNER)
(804) 281-4305
Entity
Organization
Contact information
Practice address
1401 JOHNSTON WILLIS DR, NORTH CHESTERFIELD, VA 23235-4730
(804) 281-4305
(804) 281-4310
Mailing address
1806 SUMMIT AVENUE, SUITE 300 #506, RICHMOND, VA 23230
(804) 281-4305
(804) 281-4310
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
06/20/2021
Last updated
06/20/2021
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